Get Alert
Please Wait... Processing your request... Please Wait.
You must sign in to sign-up for alerts.

Please confirm that your email address is correct, so you can successfully receive this alert.

Articles   |    
Trends in Psychotropic Polypharmacy Among Youths Enrolled in Ohio Medicaid, 2002–2008
Cynthia A. Fontanella, Ph.D.; Lynn A. Warner, Ph.D.; Gary S. Phillips, M.A.S.; Jeffrey A. Bridge, Ph.D.; John V. Campo, M.D.
Psychiatric Services 2014; doi: 10.1176/appi.ps.201300410
View Author and Article Information

Dr. Fontanella and Dr. Campo are with the Department of Psychiatry and Behavioral Health, Wexner Medical Center, and Mr. Phillips is with the Department of Biostatistics, all at Ohio State University, Columbus (e-mail: fontanella.4@osu.edu). Dr. Warner is with the Department of Social Work, University of Albany, Albany, New York. Dr. Bridge is with the Department of Pediatrics, Ohio State University, and the Research Institute, Nationwide Children’s Hospital, Columbus, Ohio.

Copyright © 2014 by the American Psychiatric Association

text A A A
PDF of the full text article.

Objective  This study examined polypharmacy patterns and rates over time among Medicaid-enrolled youths by comparing three enrollment groups (youths in foster care, with a disability, or from a family with low income).

Methods  Serial cross-sectional trend analyses of Medicaid claims data were conducted for youths age 17 and younger who were continuously enrolled in Ohio Medicaid for a one-year period and prescribed one or more psychotropic medications during fiscal years 2002 (N=26,252) through 2008 (N=50,311). Outcome measures were any polypharmacy (three or more psychotropic medications from any drug class) and multiclass polypharmacy (three or more psychotropic medications from different drug classes).

Results  Both types of polypharmacy increased across all three eligibility groups. Any polypharmacy increased from 8.8% to 11.5% for low-income youths (adjusted odds ratio [AOR]=1.12, 99% confidence interval [CI]=1.10–1.13), from 18.0% to 24.9% for youths with a disability (AOR=1.11, CI=1.09–1.13), and from 19.8% to 27.3% for youths in foster care (AOR=1.09, CI=1.07–1.11). Combinations associated with positive increases were two or more antipsychotics, two or more stimulants, and antipsychotics with stimulants.

Conclusions  Polypharmacy increased across all enrollment groups, with the highest absolute rates for youths in foster care. Both the overall prevalence and increases in prescriptions for drug combinations with limited evidence of safety and efficacy, such as the prescription of two or more antipsychotics, underscore the need for targeted quality improvement efforts. System oversight and monitoring of psychotropic medication use appears to be warranted, especially for higher-risk groups, such as youths in foster care and those from low-income households who were prescribed multiple antipsychotics.

Abstract Teaser
Figures in this Article

Your Session has timed out. Please sign back in to continue.
Sign In Your Session has timed out. Please sign back in to continue.
Sign In to Access Full Content
Sign in via Athens (What is this?)
Athens is a service for single sign-on which enables access to all of an institution's subscriptions on- or off-site.
Not a subscriber?

Subscribe Now/Learn More

PsychiatryOnline subscription options offer access to the DSM-5 library, books, journals, CME, and patient resources. This all-in-one virtual library provides psychiatrists and mental health professionals with key resources for diagnosis, treatment, research, and professional development.

Need more help? PsychiatryOnline Customer Service may be reached by emailing PsychiatryOnline@psych.org or by calling 800-368-5777 (in the U.S.) or 703-907-7322 (outside the U.S.).




CME Activity

There is currently no quiz available for this resource. Please click here to go to the CME page to find another.
Submit a Comments
Please read the other comments before you post yours. Contributors must reveal any conflict of interest.
Comments are moderated and will appear on the site at the discertion of APA editorial staff.

* = Required Field
(if multiple authors, separate names by comma)
Example: John Doe

Related Content
Gabbard's Treatments of Psychiatric Disorders, 4th Edition > Chapter 53.  >
The American Psychiatric Publishing Textbook of Geriatric Psychiatry, 4th Edition > Chapter 3.  >
The American Psychiatric Publishing Textbook of Geriatric Psychiatry, 4th Edition > Chapter 3.  >
The American Psychiatric Publishing Textbook of Geriatric Psychiatry, 4th Edition > Chapter 33.  >
APA Practice Guidelines > Chapter 16.  >
Topic Collections
Psychiatric News
Read more at Psychiatric News >>
PubMed Articles